While others jump ship, Oscar Health bets on Obamacare

Warren Dawson | June 24, 2017, 0:21

"We're confident that when the dust settles, the market for health insurance will stabilize in time for 2018", the company wrote in a blog post.

Oscar's CEO and Co-Founder Mario Schlosserannounced Wednesday the company is seeking approval from the state Department of Banking and Insurance to re-enter the health exchange, created under the Affordable Care Act.

Despite all those concerns, more than two dozen insurers have said they are making plans to continue selling coverage on the exchanges. Oscar, which lost $102 million in just its NY and New Jersey markets in 2016, has backed up the claim of other insurers, saying the government still owes them $200 million. "For all the political noise, there are simply too many lives at stake for representatives in Washington, D.C. not to do what's right for the people". The startup has filed to continue selling Oscar for Business in the state of NY, where it started to offer the service in January then rolling on to California a couple months back. It also filed to continue selling insurance to individuals, families and businesses in NY.

It's a surprisingly bold move for a company whose business model depends on the exchanges established in the Affordable Care Act, which could be repealed as soon as next week. The Senate will likely vote on that bill next week. While the Wednesday deadline does not represent a final commitment by the insurer, "it will be a good indicator of the health of these markets", said Sabrina Corlette, a research professor at Georgetown University. Its decision would cover the yawning gap left by Aetna and the state Blue Cross plan, which exited the market for next year and raised the possibility that no carrier would offer coverage to the bulk of the state's residents.

"As a result, we're seeing an increase in premiums because it's essentially the insurance companies hedging their bets that there may be the potential for them to have to pick up that CSR costs", said Marchand.

Anthem said it would not make its filings public, leaving it up to state regulators to decide whether to disclose its plans. The company said the exorbitant rate increase is necessary to remain in a market where all other insurers have fled.

The early picture for 2018 looks much like it did for previous years: Insurers are retreating from some markets or charging a lot more to stay in others. Oscar hangs the majority of its success on those exchanges and it was the ACA that helped Oscar climb to its almost three billion dollar valuation when it launched four years ago.